Assessment and Scoring - Part 1 Flashcards

Question

What does the ACPT consist of?

Answer 1

Word identification of the word dog in a series of familiar monosyllabic words that do not tax a child's linguistic and cognitive abilities Example: toy, face, teach Total of 20 monosyllabic words are repeated and rearranged to form a 96-word list presented 6 times (576 words) 15 minutes test time Performance at the beginning of the test (list 1) is compared to the performance at the end of the test (list 6) to provide an indicator of auditory vigilance

Answer 2

Criterion (failing) scores provided for each age group indicate if the scores match those of children with ADHD

Answer 3

Binaurally under headphones (or inserts) at the MCL (~50 to 60 dB HL) of the listener Test was normed for headphones so if performed in the sound field the results should be interpreted with caution This test was normed for listeners with normal hearing

Answer 4

High hit rate Hit rate (sensitivity) ~70% Miss rate ranges from 18 to 29% (misses existing ADHD)

Answer 5

Inattention error - not responding to the word dog Impulsivity error - responding to a word other than dog

Answer 6

To differentially diagnose children with ADHD from those with CAPD It can be combined with visual vigilance tests to differentially diagnose ADHD (since children with ADHD will do poorly on visual vigilance tests too)

Answer 7

38 or more

Answer 8

32 or more

Answer 9

25 or more

Answer 10

19 or more

Answer 11

16 or more

Answer 12

The less the difference between presentation 1 & 6 the higher the percentage of the sample of participants NOT diagnosed with ADHD Fewer differences = not diagnosed with ADHD

Answer 13

Screening test for CAPD Author is Keith (2009) SCAN-3: C is the older SCAN-C test reconfigured as a battery of tests SCAN = screener for central auditory nervous system 3 parts - one screener, one diagnostic, and one supplemental 10-15 minutes for the screening 20-30 minutes for the diagnostic and supplementary tests

Answer 14

Designed to identify auditory processing disorders in children in the areas of temporal processing, listening in noise, dichotic listening, and listening to degraded speech

Answer 15

Ages 5 to 12.11 years old (12 years 11 months) Children should have passed screening at 1000, 2000 & 4000 Hz bilaterally (pure tones); no ME issues as identified by tympanometry is desirable

Answer 16

50 dB HL for all SCAN-3 (children & adults) tests and sub-tests Audiometric set up for all SCAN-3 binaural tests: Ext. B = Right ear Ext. A = Left ear

Answer 17

Can be administered by school personnel and others through a CD player (no audiometer) in a quiet area at the listener's MCL If listener's MCL cannot be obtained, the tests are to be administered at the clinicians MCL MCL was found to vary significantly between and within individuals

Answer 18

Yes The biggest MCL effect was noted on the performance of the auditory figure ground, monaural low redundancy, and binaural integration types of auditory processing tasks

Answer 19

SCAN-3 users administer the test through an audiometer at 50 dB HL Further, if audiologists received SCAN-3 test results administered by other professionals, it would be important to know under what conditions/presentation level testing was performed to determine the validity of the results

Answer 20

Gap Detection [GD] (only for children 8 through 12 years) Auditory Figure Ground +8 dB [AFG8] (used as both screener and diagnostic) Competing Words–Free Recall [CWFR]*

Answer 21

Auditory Figure Ground +8 dB [AFG8]# (do not do if done in screener) Filtered Words [FW] Competing Words–Directed Ear [CWDE] (repeat the words you hear in the right ear; engaging more attention) Competing Sentences [CS] (kind of like PSI)

Answer 22

Competing Words–Free Recall [CWFR]* (do not do if done in screener) Auditory Figure Ground 0 dB [AFG0] (harder than +8) Auditory Figure Ground +12 dB [AFG+12] (easier than +12; could suggest improvement with FM system) Time Compressed Sentences [TCS]) - speech is faster; puts stress on the system

Answer 23

You hear the word, you say it Not telling them which ear to listen to

Answer 24

Filter out some frequencies of a word Can still tell what the word is due to auditory closure

Answer 25

Age range: 8-12.11 Screens disorders of timing within the auditory system (such as temporal processing disorders) Presents two tones separated by a gap ranging from 0 to 40 ms Ask if one or two tones is heard (gap detection threshold is the smallest interval where a listener consistently identifies 2 stimuli)

Answer 26

Practice test is track 3 (if the child cannot respond to the practice attempts after repeated attempts do NOT administer this test) Test items are track 4

Answer 27

Tracks 5 to 9 Speaker’s voice is at +8 dB (+8 SNR) more intense than background noise “Say the word…” with multi-talker speech in the background Test presented monaurally to each ear

Answer 28

Track 6 Two practice items presented to the right ear If the child responds correctly proceed to test items If the child responds incorrectly to one practice item, pause CD and reinstruct No additional directions before practice items played to left ear If child responds incorrectly to one or both practice items (track 8) for the left ear, still proceed with test Once test begins, do not pause CD or replay test items

Answer 29

Tracks 10-12 Dichotic listening task that assesses auditory maturation or developmental delay Two practiced items and 20 test items The child hears two words simultaneously in each ear and has to repeat back both words No direction to listen to right or left ear – free recall Free recall removes the variable of attention from the task If child responds incorrectly to practice items, pause the CD, reinstruct, and replay practice items Once the test begins, do not pause the CD Circle + for each correct response Circle – for each incorrect response; no response; “I don’t know” Record incorrect responses Practice items are not scored

Answer 30

To see what kind of errors they are making

Answer 31

No If the child is younger, they only need to pass two of the three tests to pass (cannot do gap detection test on a child that is younger than 8 years)

Answer 32

A scaled score is the result of some transformation(s) applied to the raw score To report scores for examinees on a consistent scale Compared to peers Typically used for sub-tests Sensitivity is 78% if the cut off is a scaled score of < 8 Specificity is 88% if the cut off is a scaled score of < 3 *fair sensitivity and specificity

Answer 33

Yes A child who fails the gap detection test should be further evaluated for possible temporal processing disorders

Answer 34

Should be assessed further for speech in noise listening needs

Answer 35

Should be referred for further assessment Dichotic test provide information about maturation of auditory neurological pathways Two other dichotic test from the SCAN-3: C maybe performed

Answer 36

Test used to assess auditory closure skills Low pass filtering at 750 Hz (parts of the auditory signal in the stimulus word at frequencies >750 Hz are filtered out requiring the child to fill in) Determines auditory processing abilities in poor listening environments Monaural test (each ear done individually) Two practice items for right and left ear (present right first) Practice items can be repeated once Proceed to test items even if practice items are missed for the left ear

Answer 37

Dichotic listening task is used to assess development and maturation of the auditory system Two words are heard simultaneously; one in each ear The child is instructed to repeat both words; repeating the word presented to the right ear first After completed the right-ear directed items, child is then instructed to repeat the left-ear directed items Responses must be repeated correctly for each directed ear Have them point to the right and left ear before started test to ensure they know right and left Replay practice items once if needed

Answer 38

Used to assess development and maturation of the auditory system and hemispheric specialization Dichotic test with sentences presented to both ears simultaneously The child is instructed to only repeat back sentences from the right ear for test items 1-10 and only sentences from the left ear for test items 11-20 Younger children may have difficulty repeating back only the sentences from one ear (but don't stop the test) Ask them to point to right and left ear Need to get bolded words right

Answer 39

May administer this test if child does not pass the AFG +8 Monaural test; each ear tested individually Supplementary test

Answer 40

May administer this test if more information is needed for a child’s ability to listen in noise Monaural test; each ear tested individually Supplementary test

Answer 41

Designed to assess a child’s ability to process speech presented at a rapid rate Monaural test, each ear tested separately Five practice items recorded at a normal rate to make sure that child can repeat the length of the sentence Model the practice items if child repeats them incorrectly or at a faster than normal rate Practice items can be replayed once If the child cannot repeat the practice items, do not proceed with the test No practice items for the left ear

Answer 42

A careful interpretation the test battery scores Consideration of the pattern of the test scores Consideration of other factors including

Answer 43

Used in scoring It is the mathematical difference between the right ear and left ear raw scores A positive value indicates a right ear advantage and a negative value indicates a left ear advantage Powerful indicators of a possible hemispheric dominance for language and neurologically-based language learning disorders (the more extreme the advantage, the greater possibility of an auditory-based language or learning disorder)

Answer 44

Yes It may indicate poor localization of hemispheric function related to a language disorder

Answer 45

All tests except the screening tests (wouldn't move on to the diagnostic tests if they passed the screening)

Answer 46

Yes Such as competing words – directed ear, competing words – free recall, and competing sentences

Answer 47

Yes Such as auditory figure ground, filtered words, and time-compressed sentences

Answer 48

Yes Occurs as the corpus callosum matures The REA is minimal often by early adolescence (~12 years) and typically disappears by late adolescence (~18 years)

Answer 49

A careful interpretation the test battery scores Consideration of the pattern of the test scores Consideration of other factors including information from parents/caregivers, behavioral observations of the clinician during the test, the child’s medical history, and the child’s academic performance

Answer 50

Scaled scores are normative scores specifically used to compare a child’s performance to their same-age peers These scores are derived from the test raw score that are converted to a score metric with a mean of 10 and SD of 3 The range is 1 to 19 A scaled score of 10 corresponds to an average performance within the given age-group Scaled scores of 7 and 13 are 1 SD below and above the mean, respectively

Answer 51

Appendix C

Answer 52

Provides information in the areas of degraded speech, listening in noise, and dichotic listening Derived from summing the scaled scores of AFG +8, Filtered words, CW-Directed Ear, and Competing Sentences Then converting the sum to a composite score using the table in Appendix D Composite score is based on a metric with a mean of 100 and a SD of 15 Range is 40 to 160 Score of 100 is average of any given group

Answer 53

Confidence intervals allows you to determine with 90% or 95% probability or confidence that a certain range of scores contain a hypothetical “true” score within that range (every test has some degree of error) Can only span the possible range for test scaled scores (1 to 19) The critical value for building a CI is 2 (cannot have a CI if they score a 1, they would not have a range below their score) The CI for the APC score can extend beyond possible range of 160

Answer 54

Provides age-based percentile ranks for scaled and composite scores to indicate a child's performance to other children of the same age

Answer 55

Childs current auditory processing skills Correspond to a deviation form a mean of 100 Help communicate the information better rather than discussing less easily understood descriptors

Answer 56

Yes But some still think it shouldn't be used for diagnostic purposes

Answer 57

For adolescents and adults CAPD assessment Ages 13 to 50:11 years Sub tests are the same as SCAN-3 C Pass criterion is stricter for all tests Screener takes 10 to 15 minutes to complete Diagnostic assessment takes 30 to 45 minutes to complete

Answer 58

Statistical measures that can be applied to individual and combinations of tests to determine maximum diagnostic value of tests Measures include sensitivity and specificity, ROC curves, and factor analysis (reducing a large number of variables into a fewer number of factors)

Answer 59

A single best test (or combination of tests) considered the current preferred method of diagnosing a particular disease No gold standard test for CAPD, only gold standard group

Answer 60

Known to have the disorder Typically patients with confirmed neurologic lesions of the CNS Control group includes individuals without the lesions

Answer 61

Auditory pattern/temporal ordering (APTO) tests - could be done using gap detection test Monaural separation closure (MSC) - are you able to close the separation Binaural integration/binaural separation (BIBS) - integrate and separate information between ears

Answer 62

Developed as an effort to develop a quas-behavioral gold standard for CAPD This work involved a series of studies and factor analysis to design careful test strategies One test from each of the above domains (auditory pattern/temporal ordering, monaural separation closure, and binaural integration) was recommended for inclusion in a test battery, which increased the sensitivity of the test battery vs. using any one test by itself

Answer 63

Case history Pre-test standardized questionnaires CHAPS; SIFTER; Fisher, etc. Behavioral measures Pure-tone audiometry Speech audiometry (C)APD behavioral tests in the four important auditory processing areas Other tests as needed such as attention or speech-in-noise tests Electophysiologic measures Immittance audiometry (including acoustic reflex thresholds) Otoacoustic emissions (TEOAEs or DPOAEs) ABR, mid- and late-latency auditory evoked responses Psychoeducational evaluation Speech and language evaluation

Answer 64

Prenatal and postnatal Developmental Medical Academic (failed grades, current academic performance, areas of strength/weakness, special education services) Family (genetic, medical, first-degree relatives with developmental disorders) Social (shy, aggressive, friendly, etc., plays/interacts comfortably with peers; prefers younger children/adults) Results of other evaluations (psychoeducational; speech and language evaluation) Work history; if patient is an adult

Answer 65

Yes They place fewer demands on the healthcare system Are more accessible Less invasive and less dangerous Less expensive Less time-consuming Less physically and psychologically uncomfortable for patients *however, often imperfect and sometimes ambiguous (important to determine the extent to which these tests are able to identify the likely presence of CAPD)

Answer 66

Screening (questionnaire) 7 years old and older 36 item checklist divided into 6 listening conditions and functions Each item scored on a 7-point scale Used by parents and teachers Evaluates listening behaviors in diverse listening situations, assesses child's ability in comparison to peers, used as part of the screening process to identify children experiencing listening difficulties because of hearing loss and CAPD

Answer 67

First through fifth grade Ideally completed by teacher 15 questions (three in each 5 categorial areas) Areas: academics, attention, communication, class participation, and social behavior Educationally screening students with known or suspected hearing loss Classroom teacher compares child’s functional ability to peers Can be used to track child’s performance over time

Answer 68

Provides good information on children’s functional listening abilities in the classroom (more restricted in scope than CHAPS) Completed by teachers Itemizes behaviors such as failure to attend to instructions, need for repeated instructions, easy distraction by auditory stimuli, degrading processing in a competing acoustic environment, also addresses attention and memory issues, several questions related to language-based deficits such as discrimination ability Contains 25 items, each with a value of 4% The observer is instructed to place a checkmark next to each item that is consistent with the exhibited behavior of the child Items not selected by the observer are multiplied by 4 to determine a total percentage

Answer 69

72% Children who scores at or below this should be referred for a full diagnostic test

Answer 70

Yes It covers a broad range of characteristics by only a small number of items related to listening Neither does it take into account listening behaviors of children with (C)APD depending on different listening environments

Answer 71

No, should be used to highlight concerns about a child Found that there is poor reliability between these screening tests to predict the individual test results and the overall risk for CAPD

Answer 72

Yes Offered by TAPS-R Two groups of skills are at least weaking correlated Significant deficits in short-term/working memory could influence performance on tests for (C)APD

Answer 73

Yes The screening tests (like the ones in the SCAN-3C are better predictors of the diagnosis of CAPD) Reduced costs, reduced over-referrals, time savings, and increased efficiency of identification and intervention will result from just doing the screening

Answer 74

OAEs Immittance audiometry ABR (early-latency response) Mid-latency auditory evoked response Late-latency auditory evoked response

Answer 75

Auditory evoked responses measure neuromaturation and neuroplasticity of the central auditory pathways Electrophysiologic tests provide additional information about integrity of the CNS This information may be important for purposes of differential diagnosis and site-of-lesion for some children *useful for ruling out other disorders, not necessarily for diagnosing CAPD

Answer 76

Yes Speech-based tests are sensitive to phonological and linguistic impairments, which makes it difficult to disentangle auditory from other impairments Not just based on perceptual processing, but also phonological processing (difficult for non-native speakers) Memory and attention can also impact these tests Verbal test responses may be affected by expressive skills

Answer 77

Different speech stimuli presented to each ear simultaneously May assess either binaural integration or binaural separation Sensitive to lesions of the CC and cerebral cortex

Answer 78

Monotic presentation to assess each ear independently Often tones rather than speech Assesses pattern perception and temporal functioning abilities More sensitive to a compromised right hemisphere (if test requires a verbal response, it is then sensitive to left hemisphere lesions)

Answer 79

Binaural tests (either the same ear or different) The information is presented in either a non-simultaneous, sequential manner or only a portion of the message is presented to each ear These tests assess integration between two ears Takes place at the auditory brainstem

Answer 80

Speech is redundant Involves modification of the acoustic signal to reduce the amount of redundancy Degraded speech by modifying frequency, temporal, or intensity characteristics Moderately sensitive to cortical lesions (not brainstem)